351 4TH ST - HVAC CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
Jw ATLANTIC BEACH,FL 32233
%' INSPECTION PHONE LINE 247-5814
MECHANICAL RESIDENTIAL HVAC -
MUST CALL BY 4PM FOR NEXT DAY INSPECTION: 247-5814
PERMIT INFORMATION:
PERMIT NO: ACRS17-0238
Description: HVAC- 1 A/C, 1 AHU, 3 TON
Estimated Value: 0
Issue Date: 11/28/2017
Expiration Date: 5/27/2018
PROPERTY ADDRESS:
Address: 351 4TH ST
RE Number: 169839 0000
PROPERTY OWNER:
Name: PICKETT CHARLES DAVID
Address: 351 4TH ST
ATLANTIC BEACH, FL 32233-5343
GENERAL CONTRACTOR INFORMATION:
Name:
Address:
Phone:
Name: COOL R US
Address: 6900 PHILIPS HWY SUITE 46 LEK GJOKA, QUALIFIER
JACKSONVILLE, FL 32216
Phone:
PERMIT INFORMATION:
Please see attached conditions of approval.
WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF
COMMENCEMENT MAY RESULT IN YOU PAYING TWICE FOR
IMPROVEMENTS TO YOUR PROPERTY. A NOTICE OF
COMMENCEMENT MUST BE RECORDED AND POSTED ON THE JOB
SITE BEFORE THE FIRST INSPECTION. IF YOU INTEND TO OBTAIN
FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY
BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT.
* A notice of Commencement is only required for work exceeding an estimated value of
$2,500. For HVAC work, a Notice of Commencement is only required when HVAC work
exceeds and estimated value of$7,500.
Mar 12 2000 4: 26PM COOL R US 9042812109 , page 1
MECHANICAL PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Rd Atlantic Beach, FL 32233
Ph(904) 247-5826 Fax(904)247-5845 (A.a,R S( 7 - Oz 3
OB ADDRESS: BS-1 4 1t ' 44( t(iG &a� ,1/, PERMIT#
PROJECT VALUE$ - G 3 ARI# ?c6 ,--1El REQUIRED
Air Handlini Equipme 1 t Only Air Handling Unit & Condenser Condenser Only
STEW AIR CONbITIO I G & HEATING SYSTEM INSTALLATION
Air Conditioning: Unit I antity�� Tons Per Unit
Heat: _ i Unit Q antity BTU's Per Unit Seer Rating
Duct Systems: Total C M REQUIRED
tEPLACEMEN'CF AIR C I NDITIONING& HEATING SYSTEM INSTALLATION
Air Conditioning: Unit Q tity l{ Tons Per Unit
3
Heat: ; Unit Q tity I BTU's Per Unit 3 (� dc) Seer Rating /4
Duct Systems: ; Total C I M REQUIRED
IRE PREVENTION
Fire Sprinkler System Quantity . (Requires 3 sets oflana
Fire Standpipe 1 Quantityp )
(Requires 3 sets of plans)
Underground Fnte Main Value (Requires.3 sets of plans)
Fire Hose Cabints Quantity (Requires 3 sets of plans)
Commercial Hoods Quantity (Requires 3 sets of plans)
Fire Suppression Systems Quantity (Requires 3 sets of plans)
IRE PLACES MISCELLANEOUS:
Prefabricated Fireplace Qty Automobile Lifts
Gas Piping Outltts Boilers BT(J's
Elevators/Escalators
LLL O'T'HER GAS PIPIN t Heat Exchanger
Quantity of OutlOts Pumps
#Vented Wall Firnaces Refrigerator Condenser BTU's
#Water Heaters i Solar Collection Systems
. Tanks (gallons)
Wells
)TIER: i L Dl e, Ccot RoSNAL. , Co,-,
:rmit becomes void if work does not commence within a six mo4h period or work is suspended or abandoned for six months.I hereby certify that I have read
is application and know the same to be true and correct. All provisions of laws and ordinances governing this work will be complied with whether specified or
A. The permit does not give authori to violate the provisions o any other state or local law regulation construction or the performance of construction.
roperty Owners Nave , �a -V%f - f(chftfr Phone Number/W....02-4Z-7e6F-4
fechanical Company' t f 1e CA S5 .nr C— Office Phone,: Fax o r IC ?
i
o.Address: (#0+ $' - S 1 a 646. _3 Ci ' , ._/_,A1,_ 1r1r6 State Zip 3.2.4/6,
icense Holder(Prhtt): it.K. . 4 ! S;'e Certification/Registration# C' f f/, (p /
� i .
rots' • iig If I.icpusa l3Qlder .
�► '. PATRICIA A STARK ` �' + G ,`
'`4;' .*: MY COMMISSION#FFaisocE efore me thi&ac'�1� ' •y •_ l L 21-,..,9
r- EXPIRES October 17.2014
1 '"' Signature of Notary Public ek f Ff s • \, .
AA?►399�4tfi� Fb�16fL10tMrB�MesEoa
•
_,+em s Cash Register Receiptt Receipt Number`j �
'V
City of Atlantic Beach R3531
DESCRIPTIONACCOUNT I QTY PAID
PermitTRAK $107.00
ACRS17-0238 Address: 351 4TH ST APN: 169839 0000 $107.00
MECHANICAL $103.00
MECHANICAL BASE FEE 455-0000-322-1000 0 $55.00
AC AND REFRIGERATION 455-0000-322-1000 3 $24.00
FURNACES AND HEATING 455-0000-322-1000 1 $24.00
STATE SURCHARGES - $4.00
STATE DBPR SURCHARGE 455-0000-208-0600 0 $2.00
STATE DCA SURCHARGE 45500002080700 0 $2.00
TOTAL FEES PAID BY RECEIPT: R3531 $107.00
•
Date Paid:Tuesday, November 28, 2017
Paid By: COOL R US
Cashier: BA
Pay Method: CREDIT CARD 1
/i\
Printed:Tuesday,November 28,2017 8:25 AM 1 of 1 P
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